Form 990 for tax year 2022
Filed by COMMUNITY HOSPITAL HEALTH FOUNDATION.
Totals
- Total revenue
- $1,727,377
- Total expenses
- $489,649
- Contributions and grants received
- $1,631,751
- Grants paid
- $451,820
- Program service revenue
- $0
- Investment income
- $140,223
- Other revenue
- -$44,597
- Total assets, end of year
- $5,851,906
- Total liabilities, end of year
- $14,416
- Net assets or fund balances, end of year
- $5,837,490
- Program services expenses (Part IX)
- $451,820
- Management and general expenses
- $31,965
- Fundraising expenses
- $5,864
- Program service expenses (Part III)
- $451,820
Program services were 92.3% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.
Line items
Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.
Revenue
Part VIII, the statement of revenue.
-
1c · Fundraising events
$90,120
-
1d · Related organizations
$78,809
-
1f · All other contributions, gifts and grants
$1,462,822
-
3 · Investment income
total $105,050 · excluded $105,050
-
7a · Gross sales of assets other than inventory
securities $1,491,552
-
7b · Less cost or other basis and sales expenses
securities $1,456,379
-
7c · Gain or loss
securities $35,173
-
7d · Net gain or loss
total $35,173 · excluded $35,173
-
8a · Fundraising events: gross income
$31,626
-
8a · Fundraising events: contributions included on line 1c
$90,120
-
8b · Fundraising events: direct expenses
$76,223
-
8c · Net income from fundraising events
total -$44,597 · excluded -$44,597
Functional expenses
Part IX, the statement of functional expenses.
-
1 · Grants to domestic organizations and governments
total $431,851 · program services $431,851
-
2 · Grants to domestic individuals
total $19,969 · program services $19,969
-
11c · Fees: accounting
total $3,801 · management and general $3,801
-
11f · Fees: investment management
total $27,285 · management and general $27,285
-
11g · Fees: other
total $879 · management and general $879
-
13 · Office expenses
total $5,864 · fundraising $5,864
Balance sheet
Part X, book values.
-
2 · Savings and temporary cash investments
beginning of year $764,593 · end of year $741,225
-
3 · Pledges and grants receivable
beginning of year $900
-
11 · Investments: publicly traded securities
beginning of year $3,683,892 · end of year $5,089,579
-
15 · Other assets
beginning of year $19,602 · end of year $21,102
-
17 · Accounts payable and accrued expenses
beginning of year $97,287 · end of year $14,416
-
27 · Net assets without donor restrictions
beginning of year $2,305,628 · end of year $3,834,928
-
28 · Net assets with donor restrictions
beginning of year $2,066,072 · end of year $2,002,562
Mission and programs · 2022
Mission
TO GENERATE FUNDS TO SECURE THE FUTURE OF COMMUNITY HOSPITAL BY STIMULATING PUBLIC AWARENESS AND SUPPORT.
Activities or mission (Part I)
TO SOLICIT GIFTS, GRANTS, DEVICES AND BEQUESTS FOR THE USE AND BENEFIT OF COMMUNITY HOSPITAL ASSOCIATION OF MCCOOK.
-
TO AID COMMUNITY HOSPITAL ASSOCIATION OF MCCOOK BY THE SOLICITATION OF GIFTS, GRANTS, DEVICES AND BEQUESTS EXCLUSIVELY FOR THE USE AND BENEFIT OF THE HOSPITAL OR ITS PROGRAMS AND SERVICES. COMMUNITY HOSPITAL ASSOCIATION OF MCCOOK PROVIDES ACUTE, PREVENTATIVE, AND OTHER HEALTHCARE SERVICES ON A NONDISCRIMINITORY BASIS AND IN AN ENVIRONMENT WHICH IS RESPONSIVE TO THE UNIQUE NEEDS OF ITS PATIENTS. FUNDRAISING ACTIVITIES INCLUDE A GOLF TOURNAMENT AND CONCERT.
Expenses $451,820 · Grants $451,820
As filed on the 2022 return.
Listed in Part VII
-
Troy BruntzTROY BRUNTZ
MEMBER
- Total calculated
- $340,033
- From this org
- $0
- From related orgs
- $297,126
- Other
- $42,907
- Hours/week
- 1 + 39 related
Schedule J breakdown matched by us
- Base
- $0 + $289,611 related
- Bonus
- $0 + $6,148 related
- Other
- $0 + $1,367 related
- Deferred
- $0 + $21,202 related
- Nontaxable benefits
- $0 + $21,705 related
- Filer's total
- $0 + $340,033 related
-
Jessica BortnerJESSICA BORTNER
EXECUTIVE DIRECTOR
- Total calculated
- $127,486
- From this org
- $0
- From related orgs
- $91,211
- Other
- $36,275
- Hours/week
- 40
-
Neil GohlNEIL GOHL
CHAIR
- Total calculated
- $0
- Hours/week
- 1
-
Bruce McDowellBRUCE MCDOWELL
VICE CHAIR
- Total calculated
- $0
- Hours/week
- 1
-
Jim HallJIM HALL
SECRETARY
- Total calculated
- $0
- Hours/week
- 1
-
Matt TillerMATT TILLER
TREASURER
- Total calculated
- $0
- Hours/week
- 1
-
Beth SiegfriedBETH SIEGFRIED
TREASURER THRU 12/22
- Total calculated
- $0
- Hours/week
- 1
-
Dawna BatesDAWNA BATES
MEMBER
- Total calculated
- $0
- Hours/week
- 1
-
Kristin Stagemeyer CPAKRISTIN STAGEMEYER CPA
MEMBER
- Total calculated
- $0
- Hours/week
- 1 + 2 related
-
Kurt VosburgKURT VOSBURG
MEMBER
- Total calculated
- $0
- Hours/week
- 1 + 1 related
-
Cathy KennyCATHY KENNY
MEMBER
- Total calculated
- $0
- Hours/week
- 1 + 1 related
-
Ashley VontzASHLEY VONTZ
MEMBER
- Total calculated
- $0
- Hours/week
- 1 + 1 related
-
Rick HaneyRICK HANEY
MEMBER THRU 12/22
- Total calculated
- $0
- Hours/week
- 1 + 1 related
Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.
Schedule J
Answered yes
None.
Answered no
- 4a · Severance or change-of-control payment
- 4b · Supplemental nonqualified retirement plan
- 4c · Equity-based compensation arrangement
- 5a · Pay contingent on this organization's revenues
- 5b · Pay contingent on a related organization's revenues
- 6a · Pay contingent on this organization's net earnings
- 6b · Pay contingent on a related organization's net earnings
- 7 · Other non-fixed payments
- 8 · Paid under the initial-contract exception
The filer's explanations (Part III)
- PART I, LINE 3
- THE EXECUTIVE DIRECTOR, JESSICA BORTNER, IS PAID BY COMMUNITY HOSPITAL ASSOCIATION OF MCCOOK, A RELATED ENTITY. THE PROCESS FOR DETERMINING THE COMPENSATION OF THE EXECUTIVE DIRECTOR (ED) IS AS FOLLOWS: THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS IS RESPONSIBLE FOR SETTING THE SALARY OF THE ED. ANNUALLY, THE COMMITTEE CONDUCTS A REVIEW OF THE ED'S PERFORMANCE, ABILITIES, AND OVERALL EFFECTIVENESS. THE COMMITTEE IS PRESENTED WITH SALARY AND COMPENSATION SURVEY DATA THAT IS COMPILED BY THE HUMAN RESOURCE DEPARTMENT. ALL SOURCE DOCUMENTATION IS GIVEN TO THE COMMITTEE AS WELL AS SUMMARIES PROVIDED FOR EASE OF REFERENCE. THE EXECUTIVE COMMITTEE CONDUCTS THE PERFORMANCE REVIEW WITH THE ED AND FOLLOWS WITH A MEETING IN PRIVATE CHAMBERS TO DISCUSS THE REVIEW AND TO DELIBERATE ANY AND ALL CHANGES TO THE EMPLOYMENT AGREEMENT, INCLUDING COMPENSATION AND GOALS FOR THE FOLLOWING YEAR. CONTEMPORANEOUS RECORDS ARE KEPT OF ALL SURVEY AND COMPARABILITY DATA USED ALONG WITH THE RESULTS AND DECISIONS OF THE EXECUTIVE COMMITTEE'S MEETING ON COMPENSATION.
Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.
Grants on this return
-
GENERAL SUPPORT, EQUIPMENT, SUPPLIES, PATIENT EDUCATION, TRAINING AND SCHOLARSHIPS
-
CITY OF MCCOOK
$0
BUILD PICKLEBALL COURTS
Related organizations on this return
Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.
-
COMMUNITY HOSPITAL ASSOCIATION OF MCCOOK
501(C)(3) · HEALTHCARE · NE
Provenance
- Return type
- form_990
- Tax year
- 2022
- Filed
- 8 May 2024
- IRS schema version
- 2022v5.0
- Source object
- 202401349349302225
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